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If you have ankylosing spondylitis, a massage can be much more than a heavenly indulgence. It can soothe the body and help calm the mind in many ways, according to Dolly Wallace, NCBTMB, a nationally licensed massage therapist in Muskegon, Michigan and president of the American Massage Therapy Association. As is often the case with massage and arthritis, “it helps [provide] a little more mobility and relief from pain,” Wallace says, adding that “it can also help with stress, anxiety, and depression.” It may also help improve flexibility due to increased blood circulation, according to the Spondylitis Association of America.

Joint stiffness can often cause you to assume uncomfortable postures and positions, which leads to overuse and strain of the muscles, explains Jonathan Kirschner, MD, a physiatrist at Hospital for Special Surgery in New York. “Massage can certainly help with muscle pain and stiffness,” Dr. Kirschner says, but also notes that it doesn’t necessarily help with joint stiffness. For that, he says, physical therapy or doing light exercise is beneficial.

Best Massage for Ankylosing Spondylitis

If you’re considering massage therapy to help ease the symptoms of ankylosing spondylitis, first talk to your doctor about whether massage is safe for you and which techniques may work best.

“Different people respond to different types of massage [for ankylosing spondylitis], so it’s important to figure out which type is best for you,” Kirschner says. “One type involves tapping, and that’s usually less effective than some of the deeper, kneading types of massage.”

For some, massage can trigger an ankylosing spondylitis flare. Kirschner says that as long as the therapist is massaging over the muscles and not the joints, it should not cause a problem. “If you’re having any sort of pain or discomfort,” he says, “always tell the massage therapist, who will then be able to work around that.”

Wallace generally uses soft-tissue massage for ankylosing spondylitis. This includes stretching, some vibration, circle strokes, kneading, long gliding strokes, and mild sacral rocking. Her massage techniques change, however, depending on whether a person is in an ankylosing spondylitis flare or if the disease is under control.

“There will be certain times when a person is almost in remission, and you can be a little more aggressive and use more moderate pressure,” Wallace says. “Then there are times when [muscles are] inflamed, and you need to use a much lighter touch.”

Following the massage, Wallace uses moist heat to help reduce and relieve muscle spasms. Or, if an area is inflamed, she uses ice to help reduce swelling.

Some people experience immediate results after a massage and feel they can move better. For others, Wallace says, relief may take a little longer. Your response to massage also depends on how far your arthritis has progressed, she explains. “If the condition has progressed to the late stages, the pain may decrease but the stiffness and immobility may increase,” she says. Massage techniques will differ depending on how far along your ankylosing spondylitis has advanced.

How to Find a Therapist

It’s important to find a massage therapist you’re comfortable with and who has experience working with people with arthritis. Ask your doctor or rheumatologist if they can recommend a therapist who specializes in therapeutic massage. You can also check the website for the American Massage Therapy Association, which has a locator service to help you find a therapist in your area.

Before getting a massage, ask the therapist questions about what techniques they’ll use and whether they have experience with massage for people with ankylosing spondylitis. Wallace notes that not all massage therapists practice therapeutic massage, so it’s important to ask.

Whether medical insurance will pay for massage therapy for ankylosing spondylitis varies from plan to plan. “A lot of insurance companies are promoting wellness plans as part of preventative medicine, and some are covering massage, acupuncture, and things like that,” Kirschner says. Check with your carrier to see if it’s covered. If it is, ask how many sessions you can schedule. “Not all massage therapists accept insurance,” Wallace adds, so it’s important to ask about that, too.

The Arthritis Foundation also recommends talking to the massage therapist about your ankylosing spondylitis and which parts of your body are most affected. You should also tell the therapist if you have certain conditions such as osteoporosis, high blood pressure, varicose veins, or damaged or eroded joints, as you may need to use caution when getting a massage.

If you’re thinking about adding massage to your ankylosing spondylitis management plan, do your homework and ask the right questions to find the best therapist for you.

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